Provider Demographics
NPI:1043533508
Name:CARVALHO, TRICIA CECELIA (CRNP)
Entity Type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:CECELIA
Last Name:CARVALHO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10710 CHARTER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3258
Mailing Address - Country:US
Mailing Address - Phone:410-992-9797
Mailing Address - Fax:410-730-0942
Practice Address - Street 1:10710 CHARTER DR STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3258
Practice Address - Country:US
Practice Address - Phone:410-992-9797
Practice Address - Fax:410-730-0942
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR173055363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily